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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 6i c. 1.7—15 <br /> SITEADDRESSyN --22C�a PROPERTY TAX# PERMIT <br /> 506i-(11 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER P ka..06Pc ()((�e Phone/E-mail p.OAt.) 1701f'4.4 c 6144. <br /> Address 616-736) tt ��� t�� 1, City/State/Zip ' ut alm ( A 6/(g (( <br /> CONTRACTOR E' i,i��-E2 ;:u�- l IC rLZ( --� L&I Lic.# \f 045 //2zo j &®[?' e) >Z/53'�7 <br /> Address (� P'(;,(frl.C. JOU l Q C) Phone/Email `C25-252-3lt <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PAr-oi3A tale gi(.5 Y Phone/E-mail (175---2,52—3101 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /0 5 DGD <br /> Existing Use of Building Oe--6 HEAT SOURCE: <br /> Proposed Use of Building QCct-4-c fav/lti C Gas Electric)( Other <br /> Building type: Single Family _Duplex Townhouse Multi-Family _Commercial <br /> Type of project: New _Addition X.Remodel _Repair T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back): <br /> �vtcU IY�(� (0 2�iv t5 -- . •lint IL43 1 t, 4- I rv8 f ( f <br /> �dx�� bo ale-s5 <br /> tAesixr r-135. tU u ttl cts s_K critcta,4-.e/ vir-tee givrawpc/A0 Dar{ uhwk, RapAvv <br /> Have you started working without a permit? YES NO 3 U 66. f4a5 pL cr./frt. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn $•Alteration Repair Type of Project: New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units J Toilet <br /> Forced air systems Bathtub <br /> Gas piping ) Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater ' Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove _ Grease trap <br /> y Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> (43 2--'1J-- <br /> er#Authori gent Signature Date (Revised 2/2011) <br /> �1v <br />